Mindfulness-Based Stress Reduction Buffers Glucocorticoid Resistance Among Older Adults: A Randomized Controlled Trial. Issue 6 (July 2021)

• Record Type: Journal Article
• Authors: Lindsay, Emily K.; Creswell, J. David; Stern, Harrison J.; Greco, Carol M.; Dutcher, Janine M.; Lipitz, Sarah; Walsh, Catherine P.; Wright, Aidan G.C.; Brown, Kirk Warren; Marsland, Anna L.
• Is Part Of: Psychosomatic medicine. Volume 83:Issue 6(2021)
• Publication Date: 2021-07
• Subjects: mindfulness -- glucocorticoid -- loneliness -- older adulthood -- immune function -- GC = glucocorticoid -- GCR = glucocorticoid resistance -- HEP = Health Enhancement Program -- HPA = hypothalamic-pituitary-adrenal -- IC50 = half maximal inhibitory concentration -- IL-6 = interleukin-6 -- MBSR = Mindfulness-Based Stress Reduction -- MLM = mixed-effects linear model; Medicine, Psychosomatic -- Periodicals; 616.0805
• DOI: 10.1097/PSY.0000000000000928
• Languages: English
• ISSNs: 0033-3174

Abstract

ABSTRACT: Objective: Mindfulness interventions have been effective for improving a range of health outcomes; however, pathways underlying these effects remain unclear. Inflammatory processes may play a role, possibly through increased resistance of immune cells to the anti-inflammatory effects of glucocorticoids (i.e., glucocorticoid resistance, or GCR). Here, we conducted an initial examination of whether mindfulness training mitigates GCR among lonely older adults. Methods: Lonely older adults (65–85 years; n = 190) were randomly assigned to an 8-week Mindfulness-Based Stress Reduction (MBSR) or a matched Health Enhancement Program (HEP). Whole blood drawn before and after the intervention and at 3-month follow-up was incubated with endotoxin and varying concentrations of dexamethasone, and interleukin-6 production was assessed using enzyme-linked immunosorbent assay. GCR was assessed as the concentration of dexamethasone required to decrease the stimulated interleukin-6 response by 50% (half maximal inhibitory concentration), with higher concentrations indicating greater GCR. Mixed-effects linear models tested time (pre, post, follow-up) by condition (MBSR versus HEP) effects. Results: There was no overall time by condition effect on GCR across all time points. However, a significant time by condition effect was observed from preintervention to postintervention ( d = 0.29), such that MBSR buffered increases in GCR observed in the HEP group. Although MBSR showed small, nonsignificant reductions in GCR from preintervention to 3-month follow-up, group differences were not maintained at the 3-month follow-up ( d = 0.10). Conclusions: Results suggest that MBSR may protect against declines in the sensitivity of immune cells to the anti-inflammatory effects of glucocorticoids among at-risk lonely older adults and show value in studying this biological mechanism in future trials. Trial Registration: Clinical Trials identifier NCT02888600. Abstract : Supplemental digital content is available in the text.